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Active: 556 users

How to Heal and Prevent Computer Injury (RSI)

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Smgzy
Profile Joined May 2010
United States187 Posts
Last Edited: 2011-07-07 22:51:17
July 07 2010 07:04 GMT
#1
Hello Team Liquid!

Since January, I have been dealing with several forms of RSI, that is, Repetitive Stress Injury which is a type of injury most serious gamers will probably encounter in some form, even if it's only a light discomfort. During the course of my recovery, I have done a great deal of research and study on what can be done to heal these types of injuries.

I had to personally develop a plan for myself to try to get on track to recover fully for the release of Starcraft 2, and so far things are going well enough for me to try to write this up, so I would greatly like to share the information with anyone.

I hope to help users with light to mild pain deal with it cheaply and effectively.

I will cover the topics of workstation layout, posture, exercises and stretches for the following conditions:

  • Tendonitis of the wrist, forearm, hand, and elbow(also known as tennis elbow or mouse elbow)
  • Carpal Tunnel Syndrome
  • Cubital Tunnel Syndrome

+ Show Spoiler [What is RSI?] +

From Wikipedia:

Repetitive strain injury (RSI) (also known as repetitive stress injury, repetitive motion injuries, repetitive motion disorder (RMD), cumulative trauma disorder (CT), occupational overuse syndrome, overuse syndrome, regional musculoskeletal disorder) is an injury of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces), or sustained or awkward positions.


Ergonomic Workstation Guide:

When I first found myself having pain in my arms and hands, the first thing I asked myself was "what has changed?" The only thing that had changed since before the pain started happening was my desk height. The height of my desk was too high and causing me to have terrible posture, resulting in me putting pressure on the carpal tunnel and cubital tunnel of my right hand, and the cubital tunnel of my left hand. The thing that really agitated this was the mashing the f keys while resting my arm on the left armrest of my chair. The major extension of my pinky really did a number on me, and even as I type this now I can still feel it.

I knew something had to be wrong with my workstation, and oh boy it really was. It was extremely hard for me to access a guide with extensive knowledge how I should be positioned in all ways for a workstation. Thankfully Cornell University has an ergonomics department, and after going through their information, I found a very comprehensive guide to how to setup a workstation.

There are a number of obvious choices such as split keyboards and ergonomic mice for maximum health and comfort. According to Cornell University, wrist alignment is much more important than hand position.

+ Show Spoiler [Ergonomic Workstation] +

  • Wrist rests - these were very popular a few years ago, but research studies haven't demonstrated any substantial benefits for wrist rests. In fact, a wrist rest can actually increase pressure inside the carpal tunnel by compressing the undersurface of the wrist (take a look at your wrist and you'll probably see blood vessels that shouldn't be compressed!). Studies by Dr. David Rempel at the University of Berkeley, California, show that pressure applied to the underside of the carpal tunnel is transferred into the tunnel itself via the transverse carpal ligament and that intracarpal pressure doubles with a wrist rest compared with floating the hands over a keyboard. If you choose to use a wrist rest, using one with a broad, flat, firm surface design works best, and rest the heel of your palm on this NOT your wrist. Try not to rest while you're actually typing, but rest in between bursts of typing movements. Avoid soft and squishy wrist rests because these will contour to your wrist, restrict the freedom of movement of your hands, and encourage more lateral deviation during typing. Look at the surface of a typical wrist rest that's been used and you'll see that it gets eroded away, which means that the user has been sliding their wrists over the surface which also compresses the blood vessels often visible at the wrist. Remember, your hands should be able to glide above the surface of a wrist rest during typing, don't lock them in place on the rest while you type.

  • Chair armrests - Having armrests on a chair can be helpful to aid getting into and getting out of the chair. Also, the armrests can be useful for the occasional resting of the arms (e.g. when on the phone, sitting back relaxing). However, it is not a good idea to permanently wrest the forearms on armrests while you are typing or mousing because this can compress the flexor muscles and some armrest can also compress the ulnar never at the elbow. Ideally, it should be easy to get the armrests out of the way when you need to have free access to the keyboard and mouse. These days most office chairs have armrests and many of them have adjustable height armrests, so look for a chair that is a comfortable fit to you and that has broader, flatter, padded armrests that you can easily move out of the way if needed is the best approach. If you are able to occasionally rest your hands on the keyboard on a palm rest and if you have a comfortable chair that does not have any armrests then this is also quite acceptable.



  • Put the monitor at a comfortable height that doesn't make the user tilt their head up to see it or bend their neck down to see it. When you are seated comfortably, a user's eyes should be in line with a point on the screen about 2-3" below the top of the monitor casing (not the screen). Sit back in your chair at an angle of around 100-110 degrees (i.e. slight recline) and hold your right arm out horizontally, your middle finger should almost touch the center of the screen. From that starting position you can then make minor changes to screen height and angle to suit. Research shows the center of the monitor should be about 17-18 degrees below horizontal for optimal viewing, and this is where it will be if you follow the simple arm extension/finger pointing tip. You actually see more visual field below the horizon than above this (look down a corridor and you'll see more of the floor than the ceiling), so at this position the user should comfortably be able to see more of the screen. If the monitor is too low, you will crane their neck forwards, if it's too high you'll tilt their head backwards and end up with neck/shoulder pain.

  • viewing distance - the monitor should be at a comfortable horizontal distance for viewing, which usually is around an arms length (sit back in your chair and raise your arm and your fingers should touch the screen). At this distance you should be able to see the viewing area of the monitor without making head movements. If text looks too small then either use a larger font or magnify the screen image in the software rather than sitting closer to the monitor.

  • Make sure that the user can reach the keyboard keys with their wrists as flat as possible (not bent up or down) and straight (not bent left or right).

  • Make sure that the user's elbow angle (the angle between the inner surface of the upper arm and the forearm) is at or greater than 90 degrees to avoid nerve compression at the elbow.

  • Make sure that the upper arm and elbow are as close to the body and as relaxed as possible for mouse use - avoid overreaching. Also make sure that the wrist is as straight as possible when the mouse is being used.

  • Make sure the user sits back in the chair and has good back support. Also check that the feet can be placed flat on the floor or on a footrest.

  • Make sure the head and neck are as straight as possible .

  • Make sure the posture feels relaxed for the user.



[image loading]

simply put

You can't set a flat work surface at an appropriate height for the 5 main tasks of office work - keyboarding, mousing, writing, viewing documents and viewing the screen- these all require different heights for an optimal arrangement. A negative-slope keyboard tray system serves as the height and angle adjustment mechanism for the keyboard, and the mouse platform serves as the height and angle adjustment for the mouse when attached to a work surface that is set for writing height. Monitor height is best adjusted by a separate monitor pedestal rather than trying to move a whole work surface. There are a number of new split work surface designs that may work quite well to achieve optimal monitor positioning.



With all that being said, my "workstation" could hardly even be called such. I rest my monitor on a folding card table, with my mouse and keyboard on a separate, height adjustable laptop table. The laptop table can be purchased for about 30-40 bucks, and the folding table well... it's a folding table. I recently made the switch from a keyboard with scissor switches(laptop style keys) to a keyboard with mechanical switches and noticed a great deal of comfort, along with owning the best keyboard I have ever used.

The point I'm making here is that you don't really have to go all out to be comfortable in your work station. It's nice to have a cool looking one but a cardtable and adjustable smaller table for my keyboard worked perfectly fine for me and probably cost about 50 USD in total.


Stretches:

If you think you are suffering from RSI, and you have narrowed it down to a certain condition, certain stretches may be more beneficial for relieving the stress on your tendons and muscles than others, but I would personally recommend doing all of them as a preventative measure. If you any really bad pain during any of these stretches, you should probably go see a doctor.

I'd recommend holding these for about 10-15 seconds each, doing them 3 times a day minimum, up to 10 times a day.

+ Show Spoiler [Hand Stretch] +


Make a fist, then spread your fingers as far as possible. I typically hold my fingers stretched for about 10-15 seconds.
[image loading]


+ Show Spoiler [Wrist Stretches] +


This probably helped me out the most personally. Stick your arm out, palm facing down. Keep your arm straight and tilt your wrist up so your hand is vertical until you feel a pulling in the back of your hand.
[image loading]


+ Show Spoiler [Forearm Stretches] +


Arm stretched out, palm facing up, pull your palm back with your opposite hand while keeping your arm stretched and elbow locked.
[image loading]

One other stretch that doesn't do much for me but people might find helpful is basically doing this only instead of using your other hand, push your palm against a wall, and then to pull your thumb up. I've read it's useful for pain in the thumb and that area of the hand.



Of course, all stretching is good, so if you can think of any more, do them! It helps believe me.


Exercises:

The goal in these exercises is to strengthen the core muscle groups that we use when on the computer.

What you'll need:

  • 1lb / .5kg dumbbell
  • 2lb / 1kg dumbbell
  • Grip Strengthening Tool / Stress Ball
  • Rubber Band

For grip strength even a tennis ball works here for or even a wet rag. Stress balls are pretty cheap at any sporting goods store. I got mine for around 5 dollars. Here's something similar http://www.officeplayground.com/Stress-Balls-C9.aspx

Before you try these you should make make sure you have the range of motion required to perform these exercises, meaning you should be able to do all of the stretches comfortably. If you have any sort of pain while doing this you should go back to stretching and resting. Most would recommend 3 sets of 15 repetitions. I would say go until you feel a burn and then a little further and then stop and rest. Doing these every other day should be fine.

Starting with the lightest weight you have, here is a simple exercise routine that should cover everything. Finish it off with the ball squeeze or gripping exercise tool you have.

+ Show Spoiler [exercises] +
[image loading]


Just a random note / trick that I picked up about the rubber band. If you twist the rubber band between each finger you can have a much easier time keeping it from rolling up your hand. I had a much easier time doing the rubber band exercise after learning how to do this.

With this routine, I have been able to ease my way back into personal computer use, and I plan on following it for my lifetime so that I hopefully don't slip into injury again.

Stay healthy!

Update: Another thing I would recommend doing is going to a nice massage place. If you are gaming and having complications in your forearms from playing so much there's no better way to relieve the stress / lactic buildup in your forearms. I now go once a month to get a regular massage and I believe that this has helped me out quite a bit, almost as much as the stretching.


Thanks to flamewheel for this post about flux. I really love this program.

On December 20 2010 11:36 flamewheel wrote:
Oh yeah I found a program this year that's pretty good on your computer screen. It auto-adjusts the tint of color based on the amount of natural light available so it's better for your eyes at night.

http://www.stereopsis.com/flux/

Subversion
Profile Blog Joined April 2010
South Africa3627 Posts
July 07 2010 07:09 GMT
#2
Ah man.

I do NONE of this shit. Totally getting RSI any day now =/

I'm like a guy with a bee allergy who pisses on hives on the weekend.
flamewheel
Profile Blog Joined December 2009
FREEAGLELAND26781 Posts
July 07 2010 07:11 GMT
#3
Nice post!
I've been doing many of these stretches, though mainly it was for tennis (forearms), weightlighting (the stuff in exercises) and piano, since typing too much and playing Tetris for prolonged periods of time have started destroying the flexibility in my hands and fingers. Never really thought too much about the ergonomic workstation though, but perhaps that might be interesting to look into.
Writerdamn, i was two days from retirement
nttea
Profile Blog Joined July 2008
Sweden4353 Posts
July 07 2010 07:11 GMT
#4
what are the first signs of any of these troubles? i never felt anything but since im sitting by the computer 24/7 and have done so for most of my life i feel i should be worried ^_^
Ilikestarcraft
Profile Blog Joined November 2004
Korea (South)17726 Posts
July 07 2010 07:14 GMT
#5
Holy shit this is awesome man. Def going to favorite this.
"Nana is a goddess. Or at very least, Nana is my goddess." - KazeHydra
Djzapz
Profile Blog Joined August 2009
Canada10681 Posts
July 07 2010 07:15 GMT
#6
I dismiss all of that advice!

I have never had an "RSI" and therefore I am immune to them. I'm probably invincible too.


But yeah I'm going to fall apart in a few years if that =(
"My incompetence with power tools had been increasing exponentially over the course of 20 years spent inhaling experimental oven cleaners"
FragKrag
Profile Blog Joined September 2007
United States11552 Posts
July 07 2010 07:23 GMT
#7
nice post

Thanks for the information

I think I'll start doing them now
*TL CJ Entusman #40* "like scissors does anything to paper except MAKE IT MORE NUMEROUS" -paper
Smgzy
Profile Joined May 2010
United States187 Posts
July 07 2010 07:27 GMT
#8
On July 07 2010 16:11 nttea wrote:
what are the first signs of any of these troubles? i never felt anything but since im sitting by the computer 24/7 and have done so for most of my life i feel i should be worried ^_^



Stiffness / pain would probably be the first sign. When I first felt it it was just a small amount of pain in my pinky and along the side of my hand. Like a nagging feeling. When it lasted for multiple days I knew that it could be serious and I just ignored it which allowed it to develop into something worse.
FreezingAssassin
Profile Blog Joined March 2010
United States455 Posts
July 07 2010 07:29 GMT
#9
very very interesting. I must say i will fall to this soon since im usually looking really close to the computer, my posture is really bad im usually hunched over * i sit on beanie bags becuase we have no comp stand* and my *mouse pad* is my tower so my wrist are also in pretty bad shape. I better start to excersicing before its too late -_-
"I love when stupid stuff happens, it makes me look smart" - IdrA
Squallcloud
Profile Joined February 2008
France466 Posts
July 07 2010 07:49 GMT
#10
Nice job, my right/mouse hand definitly give me pain at work or at home. Trying this ASAP.
Firebathero fanboy - It's not that i'm dumb i'm just controlled by a retarded infestor - Day[9]
zyvox
Profile Joined June 2010
United States32 Posts
July 07 2010 07:53 GMT
#11
nice post, gonna try these too
Sephy90
Profile Blog Joined January 2010
United States1785 Posts
July 07 2010 07:59 GMT
#12
Really great post! I'll definitely be doing this, and I even tried those stretches and man did they feel good ^_^
"So I turned the lights off at night and practiced by myself"
NeoLearner
Profile Blog Joined January 2010
Belgium1847 Posts
July 07 2010 08:03 GMT
#13
I have some RSI on the index finger of right hand. Root cause is more than likely overuse...

Problem is that's not something I can fix easily. I design Electronics for a living. I'm at my pc all day making schematics, dragging-and-droppping transistors and stuff around on the screen. Then when I come home I boot me up some Starcraft which is not helping at all. Can't exactly quit my job though.

Sometimes I use my middle finger on the mouse instead. When beta started I even tried using my left hand to use the mouse. Only for a few days though, that shit is frustrating

Anyone else have index-finger problems or does anyone have positive experience with an Ergonomic Mouse?
Bankai - Correlation does not imply causation
caldo149
Profile Blog Joined April 2009
United States469 Posts
July 07 2010 08:06 GMT
#14
Wow, this is a perfectly timed post for me, my wrist started hurting a few days ago and although it stopped, i now know what to do to prevent it! thanks so much ^^ I just did the wrist stretches and they cracked just like my knuckles 0_o
Hellions are my homeboys
Lord_of_Chaos
Profile Joined June 2007
Sweden372 Posts
July 07 2010 08:15 GMT
#15
The first sign I had was that it hurt lifting a frying pan. Took me a while to understand it actually had to do with the computer.

After it healed and came back several times (when it came back I basicly stopped playing bw, and then started when it healed), I decided to basicly quit competitive gaming.

This seems really good. I do some of the exercises you show here for normal training, eventhough I have no problem with RSI anymore. I wonder if they would have helped me.

Khul Sadukar
Profile Joined August 2009
Australia1735 Posts
Last Edited: 2010-07-07 08:46:16
July 07 2010 08:39 GMT
#16
Excellent post.

Will def by doing these exercises/stretches regularly. (perfect for queuing in LoL)

Just need to get some weights. I work in IT and pretty much on a PC 90% of my awake hrs. Have had ongoing rsi issues for few years.

Recently had the right mouse click finger pain. I basically switched to using left hand at work. Not sure if theres any particular mouse that helps with that. Just make sure its not one that forces ur hand to hunch over it (my mx518 kinda did this and i had issues with fingers overextending) All depends on ur gripe style and hand size i guess.
I don't want to be part everything. I want to be something. - Weapon X
Smgzy
Profile Joined May 2010
United States187 Posts
Last Edited: 2010-07-07 22:18:45
July 07 2010 21:52 GMT
#17
On July 07 2010 17:39 Khul Sadukar wrote:
Excellent post.

Will def by doing these exercises/stretches regularly. (perfect for queuing in LoL)

Just need to get some weights. I work in IT and pretty much on a PC 90% of my awake hrs. Have had ongoing rsi issues for few years.

Recently had the right mouse click finger pain. I basically switched to using left hand at work. Not sure if theres any particular mouse that helps with that. Just make sure its not one that forces ur hand to hunch over it (my mx518 kinda did this and i had issues with fingers overextending) All depends on ur gripe style and hand size i guess.


It probably could help to switch to your other hand but unless really you make a permanent switch that is probably not going to solve the problem. If there is nothing compressing your wrist and you are keeping it straight, my guess that it could be a tendon issue of overextension like you say, which is much easier to deal with compared to carpal tunnel as long as you do some core strengthening and try to take it easy. There are a number of ergonomic mice that you can use for work as well that can help to relieve stress related injury.

You should check out the Vertical Mouse
DemiSe
Profile Blog Joined May 2010
883 Posts
July 07 2010 22:09 GMT
#18
Really educational post, much thanks.
Def gonna read through this again and try implement some of the stuff.
Let's See Who's Stronger, Your Tricks, Or My Skills.
Malgrif
Profile Blog Joined March 2010
Canada1095 Posts
July 07 2010 22:10 GMT
#19
my teacher told me the best way to avoid these types of injury, above all else, is to just take breaks and don't be on the computer for 5hours + at a time.
for there to be pro there has to be noob.
Hynda
Profile Blog Joined June 2010
Sweden2226 Posts
July 07 2010 23:51 GMT
#20
I've worked up a habit of just switching hands whenever I'm not competative, so using my right arm for mouse and left for keyboard while gaming ect and then just going mouse in left whenever I'm just browsing forums or anything like that.

I have no idea if this actually helps, but I've never felt any kind of symptoms of these things. It would be neat if anyone with some kind of insight knows if it's just a quirky habit or of actual help.
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